Teepa Snow, a renowned occupational therapist and dementia care educator, developed the "GEMS" model as a way to describe and understand the different stages of dementia. In this model, each stage is represented by a different gemstone, reflecting the unique qualities and abilities of individuals with dementia at each stage. Here are the different stages of dementia as described by Teepa Snow's GEMS model:
- Sapphire (GEM 1): The Sapphire stage represents individuals who are in the earliest stages of dementia or have minimal cognitive impairment. At this stage, cognitive abilities are relatively preserved, and individuals may still be able to perform activities of daily living independently. Memory loss and cognitive decline are subtle, and individuals may exhibit occasional forgetfulness or difficulty with complex tasks.
- Diamond (GEM 2): The Diamond stage represents individuals with mild cognitive impairment or early-stage dementia. Cognitive changes become more noticeable, with difficulties in memory, attention, and problem-solving. However, individuals in this stage often retain significant functional abilities and may still engage in meaningful activities and social interactions with support.
- Emerald (GEM 3): The Emerald stage represents individuals with moderate dementia. At this stage, cognitive impairment becomes more pronounced, and individuals may struggle with tasks such as remembering recent events, following conversations, and managing finances. Functional abilities may decline, requiring assistance with instrumental activities of daily living (IADLs) such as cooking, cleaning, and transportation.
- Amber (GEM 4): The Amber stage represents individuals with moderately severe dementia. Cognitive deficits are more severe, with significant memory loss, language difficulties, and impaired judgment. Individuals may experience confusion, disorientation, and agitation, requiring increasing levels of supervision and support with activities of daily living (ADLs).
- Ruby (GEM 5): The Ruby stage represents individuals with severe dementia. At this stage, cognitive impairment is profound, and individuals may have limited verbal communication and require assistance with all aspects of daily care. Behavioral symptoms such as agitation, aggression, and wandering may be more prevalent, necessitating specialized care and support.
- Pearl (GEM 6): The Pearl stage represents individuals with very severe dementia. In this stage, cognitive function is severely impaired, and individuals may have minimal awareness of their surroundings or ability to communicate verbally. Physical care needs are extensive, and individuals require round-the-clock supervision and assistance with all activities of daily living.
Teepa Snow's GEMS model provides a person-centered approach to understanding and supporting individuals with dementia, recognizing their unique strengths, abilities, and needs at each stage of the disease. All of our Care Coordinators at Tender Rose were trained in-person on the GEMS model by Teepa Snow herself, and this has optimized the way that we understand the disease process to better care for our clients. We offer training workshops for family caregivers on the GEMS model; explore Tender Rose Academy for more details.
By using gemstones as metaphors, the model emphasizes the value and dignity of individuals with dementia, highlighting the precious qualities that remain intact throughout the progression of the disease.